Generally, you will find that we will be talking about the particular issues that you find problematic. Sometimes we will be talking about your current point of view and decisions. When needed, we may examine how your family of origin affected your current situation.
Psychotherapy has both benefits and risks. The risks sometimes include experiencing uncomfortable feelings, such as sadness, guilt, anxiety, anger, frustration, loneliness and helplessness. At times, in psychotherapy, you may remember unpleasant memories. Psychotherapy often requires discussing unpleasant aspects of your life. However, psychotherapy has been shown to have benefits for individuals who undertake it. Therapy often leads to a significant reduction in feelings of distress, increased satisfaction in interpersonal relationships, greater personal awareness and insight, increased skills for managing stress, and resolutions to specific problems. But, there are no guarantees about what will happen. Psychotherapy requires a very active effort on your part. In order to be most successful, you will have to work on things that we discuss outside of sessions. While you might have a number of insights to your problems in our sessions, for psychotherapy to work, you must be able to apply these insights to make lifestyle changes outside of the therapy session.
The first few sessions will involve a comprehensive evaluation of your needs. By the end of the evaluation at our first session, I will be able to offer you some initial impressions of what our work may include. At that point, we will discuss your treatment goals and create a personalized, initial treatment plan, if you decide to continue. You should evaluate this information as well as your own assessment about whether you feel comfortable working with me. Therapy can involve a large commitment of time, money, and energy, so you should be very careful about the therapist you select. If you have questions about my procedures, we should discuss them whenever they arise. I normally conduct an evaluation that will last from 1 to 3 sessions. During this time, we can both decide if I am the best person to provide the services you need in order to meet your treatment goals. If not, I will be happy to refer you to available resources in the community.
The purpose of coaching is to provide education and skills training to individuals who are psychologically healthy but wish to enhance their skills and satisfaction with their work, social, family and intimate lives.
Psychotherapy services are indicated when an individual has significant cognitive or emotional problems that affect a person’s ability to work, socialize, parent, maintain an intimate relationship or engage in activities of daily living. While education and coaching are involved, the psychotherapy process is engaged to restore a person to their baseline level of functioning or to ameliorate or eliminate emotional or cognitive symptoms caused by an emotional or cognitive disorder.
The purpose of coaching is to provide education and skills training to individuals who are psychologically healthy but wish to enhance their skills and satisfaction with their work, social, family and intimate lives. Unless there is some medical necessity that can be demonstrated, or unless coaching or education is specifically covered with a procedure code by your insurance, it’s unlikely that coaching will be covered by your insurance.
If psychotherapy is begun, I will usually schedule one 45-minute session (one appointment hour of 45 minutes duration) per week at a time we agree on, although some sessions may be longer or more frequent.
Psychological services are most effective when meeting times are regular and consistent. The time scheduled for your appointment is assigned to you and you alone. If you need to cancel or reschedule a session, it is required that you provide more than 24 hours notice. If you miss a session without canceling, or cancel with less than 24 hours notice, you will be responsible for payment for the missed session. It is important to note that insurance companies do not provide reimbursement for cancelled sessions. In addition, you are responsible for coming to your session on time and at the time scheduled. If you are late, your appointment will still need to end on time. Unfortunately, if you are more than 20 minutes late to an appointment we will be unable to have a session at that appointment time.
The psychotherapy services I provide are confidential to the extent permitted by law. The use of your personal health information is governed by Federal and State Laws concerning the confidentiality of personal health information (HIPAA) along with the ethical guidelines established by the American Association of Marriage and Family Therapists (AAMFT) and the Employee Assistance Professionals Association (EAPA). For more information about how I handle personal health information, please read my Notice of Privacy Practices here.
As a coach I maintain the same strict standards of confidentiality for my coaching clients as I do for my psychotherapy clients. However, the law does not recognize the confidentiality of the records I keep as a coach in the same way as it recognizes the confidentiality of personal health information obtained in the process of psychotherapy. If you have specific concerns about this, please consult your attorney before engaging in coaching services.
I am required by law to keep appropriate records of the psychological services that I provide. Although psychotherapy often includes discussions of sensitive and private information, normally very brief records are kept noting that you have been here, what was done in session, and a mention of the general topics discussed. You have the right to a copy of your file at any time. You have the right to request that a copy of your file be made available to any other health care provider at your written request. Your records are maintained in a secure location and handled according to HIPAA standards, the federal regulations governing personal health information.
Psychotherapy and coaching sessions are 45 to 50 minutes long and billed at my usual and customary fee of $125 per clinical hour or at your insurance rate if I have contracted with them. Employee Assistance Program (EAP) services are provided at no fee to the client upon receipt of authorization of services from the EAP. I will not provide EAP services without prior authorization from them. If I have not contracted with your insurance company or Employee Assistance Program, my usual and customary fee will be charged. Session fees or insurance co-pays are payable at time of service unless alternative arrangements have been made. Fees will be reevaluated periodically. You will be responsible for paying the entire fee if your insurance fails to authorize units of service or if no units of service are available to you. Should a balance accrue and no payment is received, I reserve the right to seek remuneration by any means legally possible including, but not limited to, the retention of a collection agency. I cannot go for more than 3 sessions without payment. If you are unable to pay, or if your fee becomes a burden in the course of psychotherapy, please let me know immediately so that we can arrange for necessary services elsewhere in the community or come to some appropriate financial arrangement.
Because legally related activities often are time-bound and interfere with the routine operation of my practice, often requiring rescheduling of other clients, legally related activities will be billed at $250 per 60-minute hour. Legal fees are not billable to insurance companies or employee assistance programs and will be charged to the patient directly at the rate of $250 per hour. (e.g. Document evaluation, document preparation, preparation for appearances, legal appearances, travel to and from legal appearances, contacts with attorneys with any party of the litigation, emotional support, stress reduction and psychological self-care solely related to the litigation). Printing or copying of records will be charged at $250 per 60-minute hour and at a rate of 5 cents per page.
As a courtesy, if I am a provider listed on your network, I’m happy to provide an initial contact with your insurance company to inquire about benefits; however, you should consider this an “estimate”. Nearly all insurance companies reserve the right to determine medical necessity and payment at the time the billing for services is submitted to the insurance company. Whatever determination for payment the insurance company makes, the client is responsible for any unpaid balances. If I am not a provider on your insurance company’s network, you will be responsible for determining your benefits and submitting paperwork to your insurance company for reimbursement. I will be happy to provide you with a superbill designed for submission to insurance companies.
I do not consider forensic psychology to be one of my areas of expertise and very rarely have been called upon to participate in legal proceedings. The evaluations I perform and the records I keep are for the purposes of my clinical work that include Employee Assistance Program Evaluations. There are rare occasions when my testimony and records have been requested for use in litigation; however, it should be understood from the outset that the documentation is created for clinical purposes not forensic ones. This means that the notes that I keep tend to be very general and only for the purposes of treatment planning and third party reimbursement.
Generally, I will recommend that you consult your personal physician, Employee Assistance Program or Psychiatrist for Fitness for Duty, Return to Work or Medical Leave Evaluations. I will be happy to provide my clinical opinion to your Employee Assistance Program or physician should this be necessary. However, I generally will not make the final recommendation or provide the paperwork for these types of evaluations.
I am often not immediately available by telephone. While I am usually in the office during normal business hours, I do not answer the phone when I am with a client. If you need to reach me between sessions, or in an emergency, I will make every attempt at responding in a timely manner. You may leave a message on my confidential voicemail at any time and your call will be returned as soon as possible or by the next business day under normal circumstances. After business hours Monday through Friday, I check my voicemail for messages for the last time at 5:00 PM. If this is an urgent situation, you can leave a message on my cell phone number. My cell phone number, (503) 753-3804, can always be found by calling my landline: (503) 227-3187. On weekends, I typically check for messages at 7:00 PM.
I will only return a call after 5:00 PM or on the weekend if the matter is urgent and cannot wait until the next business morning. If you require an immediate response and it is after 5 pm on weekdays or on the weekend, please be sure clearly indicate this in your message and leave a phone number and the times where you can be reached. I will make every attempt to get in touch with you as soon as possible. But, for any number of unseen reasons, if you do not hear from me or I am unable to reach you, it remains your responsibility to take care of yourself until such time as we can talk. If you feel unable to keep yourself safe, call 911 go to your nearest emergency room. Or, you can call the Multnomah County Crisis Line at (503) 988-4888.
I will make every attempt to inform you in advance of any planned absences, and provide you with a name and phone number of the therapist providing on-call services for my practice.